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Table 4 Comparisons of studies regarding HIV-infected patients admitted to ICU in the HAART era

From: Admissions to intensive care unit of HIV-infected patients in the era of highly active antiretroviral therapy: etiology and prognostic factors

City

[reference]

San Francisco

[8]

San Francisco [16]

New York

[20]

Paris

[18]

Mexico

[14]

São Paulo

[15]

Rio de Janeiro

[19]

Taipei

Study year

1996-1999

2000-2004

1997-1999

1996-2005

1996-2006

1996-2006

2006-2008

2001-2010

HIV-related characteristics

        

   Newly diagnosed HIV (%)

5.6

-

-

19.7a

26

38

28

44.4

   Median CD4 count (cells/mm3)

64

109

85

-

-

39

75

30

ICU admission diagnosis (%)

        

   Respiratory failure (%)

40.7

42.3

30.0

58.8

51.0

33.1

29

44.4

   pneumocystosis (%)

10.7

13.8

-

18.7

-

23.2

-

8.1b

   Sepsis (%)

11.9

20.3

13.0

23.9

26.0

31.2

20.5

33.3

   Neurological disease (%)

12.4

16.3

18.0

32

15.0

19.4

22.7

11.9

   Others (%)

35.0

21.1

39.0

-

21.0

16.2

27.3

13.3

Mortality predictors

        

   ART use

No prior HAART univariably increased hospital mortality, 1.8 (1.02-3.2), but not significantly in multivariable analysis

No association

No association

No association

No prior HAART independently increased ICU mortality, 3.33 (1.43-10.0)c

No ART use in ICU independently increased 6-month mortality, 2.00 (1.41-2.86)

No association

No association

   CD4 count (cells/mm3)

-

-

CD4 < 200 univariably increased hospital mortality, 2.24 (1.16-4.31), but not significantly in multivariable analysis

No association

-

CD4 < 50 independently increased ICU mortality, 2.10 (1.17-3.76)

No association

CD4 (per 10-cells/mm3 decrease) independently increased hospital mortality, 1.036 (1.003-1.069)

   Admission diagnosis of sepsis

-

No significant difference between with sepsis and respiratory failure

-

Severe sepsis independently increased ICU mortality, 3.67 (1.53-8.80)

Septic shock independently increased ICU mortality, 2.4 (1.1-5.2)c

Sepsis independently increased ICU mortality, 3.16 (1.65-6.06)

Severe sepsis/septic shock independently increased 28-day mortality, 3.13 (1.21-8.07)c

Sepsis independently increased hospital mortality, 2.91 (1.11-7.62)

   Hospital-to-ICU interval

-

-

-

Delayed ICU admission independently increased ICU mortality, 3.04 (1.29-7.71)

-

-

-

Hospital-to-ICU interval > 24 hours univariably increased hospital mortality, 2.72 (1.23-6.01), but not significantly in multivariable analysis

   Serum albumin level (g/dL)

Serum albumin < 2.6 independently increased hospital mortality, 3.5 (1.8-6.6)

Lower serum albumin (per 1-g/dl decrease) independently increased hospital mortality, 2.08 (1.41-3.06)

-

-

No association

No association

-

Lower serum albumin (per 1-g/dl decrease) univariably increased hospital mortality, 1.69 (1.04-2.74), but not significantly in multivariable analysis

  1. Values are given as odds ratio (95% confidence interval), unless otherwise indicated.
  2. aHIV diagnosis within 60 days before ICU admission.
  3. bDiagnosis was based on identification of Pneumocystis in the sputum, bronchoalveolar-lavage fluid, or transbronchoscopic or surgical lung biopsy.
  4. cValues are given as hazard ratio (95% confidence interval).
  5. ART, antiretroviral therapy; HAART, highly active antiretroviral therapy.